A new study of the 2003 outbreak of SARS in Toronto shows how fears of a virulent contagious disease can affect health-care providers and reveals that some of those surveyed who experienced SARS-like symptoms during the outbreak still went to work.
These results emerge amid current concern that another infectious disease, avian influenza, commonly known as bird flu, could cause a deadly global epidemic.
The study, to appear in the September/October issue of the journal Psychosomatics, used data from survey responses submitted by 193 physicians, including 45 who provided direct care in the three large teaching hospitals in downtown Toronto where SARS (severe acute respiratory syndrome) patients were treated.
Sherry L. Grace, lead author of the study team assembled by the University Health Network in Toronto, says the experience of Toronto’s physicians is proving enlightening. “What we have learned,” said Grace, “are some basic things to better prepare doctors everywhere with the means for battling highly infectious diseases.”
Over a five-month period, 247 probable and 128 suspected cases of SARS were reported with 44 deaths recorded, including one physician and three nurses. More than 50 percent of the Toronto SARS cases involved health care providers, with the outbreak causing widespread suspensions of clinical services and quarantines.
The main concern expressed by those surveyed was that the SARS outbreak diminished their ability to care for non-SARS patients and, as a secondary result, caused them to lose income.
Despite the fears and anxieties they expressed, those surveyed possessed and applied coping skills that proved “fairly resilient” and felt that it was their duty as physicians, according to the report, to care for highly infectious patients with life-threatening diseases.
Of the 193 physicians surveyed by mail, 35 reported experiencing SARS-like symptoms and 21 of them continued to work. The survey format did not allow follow-up questioning, and the authors recommend additional investigation of the issue.
Another finding revealed a racial component - that many respondents felt stigmatized during the SARS outbreak by others who knew they had possibly been exposed to the corona SARS virus. The initial cluster of SARS cases occurred in Hong Kong. Among the Toronto physicians surveyed, those with an Asian background reporedtreported a far higher degree of stigmatization than their Caucasian counterparts.